growth at 5 months

[nature nurture]

any suggestions out there for a mom who's baby is 5 months old and has been in the 2nd and 3rd percentile all along but is now starting to lose weight (6oz last month)? he appears healthy and happy, but he's is very small. her doctor says she needs to start both cereal and formula and she's feeling inadequate and disappointed. if she decides to start formula, how would you recommend introducing it, how much and when would be best?

i did my best to validate her as a mother, reminded her this is a common time for slower growth, suggested getting another opinion, (maybe from an LC) and told her i would look into it more... i had already spoken with her about increasing milkd supply prior to the baby's weight loss

 

thanks so much

amanda

[TiredX2]

IMO, there is a huge difference between growth slowing down (which I saw in my children) and fairly significant weight LOSS.  Are they sure that 6 ounce weight loss is accurate (same scale, scale correct, naked both times, etc...)?  That would be over 2% of body weight.

You've already talked to her about increasing milk supply?  Is she doing those things (feeding every 1-2 hours, night nursing...)?

If there are no indications of low milk supply, I'm not sure formula will help.  If she is going to start solids, make sure she does not start grain, fruits & veggies.  They are very light density for calories.  Avacodos are good.  Another option is to add oils to simple grains.  Or just oil if the baby will take it!

When you say he appears happy and healthy, are the rest of his measurements increasing as expected?  Head?  Height?  Is he rolling over?  Meeting other developmental milestones.  Is that an ongoing weight loss or is there a possiblity it was a one time innacuracy? (my DD "lost" more than that once but when we had her weighed at a different place she had, instead, gained about a point.  Obvious scale error).

[Megan73]

I've been there with low supply and felt "disappointed and inadequate" so I understand how tough it is.
But a baby who is LOSING weight - and not just because of a brief illness - is an emergency. In almost every case, baby isn't gaining because he's not getting enough milk.
Seeing a LC is a great idea. I'm certain she'll advise mom to supplement with formula or donor milk while she works on increasing her supply. I'd start by giving baby an ounce after every feed with a supplemental nursing system (a Medela SNS or Lact-Aid), a cup (a tiny medicine cup works well) or syringe.
I would not use bottles - flow preference will make the whole situation worse.
To boost her supply, mom should nurse, nurse, nurse with breast compressions, offer both breasts at every feeding - even starting again after baby finishes both breasts - co-sleep to get lots of night nursing in and pump after every feed with a good double-electric. Domperidone (there's a FAQ in breastfeeding challenges) might make all the difference.